Volume 71, Issue 2_suppl
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


We assessed the proportion of febrile children less than five years old with prompt effective antimalarial treatment and the proportion of those less than five years old sleeping under insecticide-treated nets (ITNs) or any mosquito net the preceding night in African malarious countries. Data were reviewed from 23 Multiple Indicator Cluster Surveys and 13 Demographic and Health Surveys conducted between 1998 and 2002. A median of 53% of febrile children received antimalarial treatment. A median of 84% of these treatments, however, involved chloroquine, and the proportion of treatments given within two days of onset of symptoms was unknown in most surveys. Median coverages of those less than five years old with any net and ITNs were 15% and 2%, respectively. Use of nets, and especially ITNs, was consistently lower in rural than in urban areas. At the outset of intensified malaria control under Roll Back Malaria, coverage with principal interventions was far below the target of 60% set for Africa in 2005.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Samba E, 2001. The malaria burden and Africa. Am J Trop Med Hyg 64 (Suppl): ii. [Google Scholar]
  2. Snow RW, Craig M, Deichmann U, Marsh K, 1999. Estimating mortality, morbidity and disability due to malaria among Africa’s non-pregnant population. Bull World Health Organ 77 : 624–640. [Google Scholar]
  3. Lengeler C, 2001. Insecticide-treated bednets and curtains for preventing malaria (Cochrane Review). The Cochrane Library, Issue 4: Oxford: Update Software.
  4. Phillips-Howard PA, Nahlen BL, Kolczak MS, Hightower AW, ter Kuile FO, Alaii JA, Gimnig JE, Arudo J, Vulule JM, Odhacha A, Kachur SP, Schoute E, Rosen DH, Sexton JD, Olloo AJ, Hawley WA, 2003. Efficacy of permethrin-treated bed nets in the prevention of mortality in young children in an area of high perennial malaria transmission in western Kenya. Am J Trop Med Hyg 68 (Suppl): 23–29. [Google Scholar]
  5. Kidane G, Morrow RH, 2000. Teaching mothers to provide home treatment of malaria in Tigray, Ethiopia: a randomised trial. Lancet 356 : 550–555. [Google Scholar]
  6. Sirima BS, Konaté A, Tiono AB, Convelbo N, Cousens S, Pagnoni F, 2003. Early treatment of childhood fevers with pre-packaged antimalarial drugs in the home reduces severe malaria morbidity in Burkina Faso. Trop Med Int Health 8 : 133–139. [Google Scholar]
  7. Pagnoni F, Convelbo N, Tiendrebeogo J, Cousens S, Esposito F, 1997. A community-based programme to provide prompt and adequate treatment of presumptive malaria in children. Trans R Soc Trop Med Hyg 91 : 512–517. [Google Scholar]
  8. Garner P, Gulmezoglu AM, 2000. Prevention versus treatment for malaria in pregnant women. Cochrane Database Syst Review 2: CD000169. [Google Scholar]
  9. Roll Back Malaria, 2000. The African Summit on Roll Back Malaria. Abuja: World Health Organization.
  10. D’Alessandro U, Olaleye BO, McGuire W, Thomson MC, Langerock P, Bennett S, Greenwood BM, 1995. A comparison of the efficacy of insecticide-treated and untreated bed nets in preventing malaria in Gambian children. Trans R Soc Trop Med Hyg 89 : 596–598. [Google Scholar]
  11. Clarke SE, Bogh C, Brown RC, Pinder M, Walraven GEL, Lindsay SW, 2001. Do untreated bednets protect against malaria? Trans R Soc Trop Med Hyg 95 : 457–462. [Google Scholar]
  12. D’Alessandro U, Buttiens H, 2001. History and importance of antimalarial drug resistance. Trop Med Int Health 6 : 845–848. [Google Scholar]
  13. Greenwood BM, Bradley AK, Greenwood AM, Byass P, Jammeh K, Marsh K, Tulloch S, Oldfield FS, Hayes R, 1987. Mortality and morbidity from malaria among children in a rural area of The Gambia, West Africa. Trans R Soc Trop Med Hyg 81 : 478–486. [Google Scholar]
  14. Slutsker L, Chitsulo L, Macheso A, Steketee RW, 1994. Treatment of malaria fever episodes among children in Malawi: results of a KAP survey. Trop Med Parasitol 45 : 61–64. [Google Scholar]
  15. Breman JG, Campbell CC, 1988. Combating severe malaria in African children. Bull World Health Organ 66 : 611–620. [Google Scholar]
  16. Kachur SP, Phillips-Howard PA, Odhacha AM, Ruebush TK, Oloo AJ, Nahlen BL, 1999. Maintenance and sustained use of insecticide-treated bednets and curtains three years after a controlled trial in western Kenya. Trop Med Int Health 4 : 728–735. [Google Scholar]
  17. Hamel MJ, Odhacha A, Roberts JM, Deming MS, 2001. Malaria control in Bungoma district, Kenya: a survey of home treatment of children with fever, bednet use and attendance at antenatal clinics. Bull World Health Organ 79 : 1014–1023. [Google Scholar]
  18. Holtz TH, Marum LH, Mkandala C, Chizani N, Robers JM, Macheso A, Parise ME, Kachur SP, 2002. Insecticide-treated bed-net use, anaemia, and malaria parasitaemia in Blantyre district, Malawi. Trop Med Int Health 7 : 220–230. [Google Scholar]
  19. van Bortel W, Barutwanayo M, Delacollette C, Coosemans M, 1996. Motivation à l’acquisition et à l’utilization des mostiquaires imprégnées dans une zone à paludisme stable au Burundi. Trop Med Int Health 1 : 71–80. [Google Scholar]
  20. Chambon R, Lemardeley P, Louis FJ, Foumane V, Louis JP, 1997. Bull Soc Pathol Exot 90 : 364–369. [Google Scholar]
  21. Netmark, 2001. Netmark baseline survey on insecticide-treated materials (ITMs): cross-national summary of findings. Net-mark, a regional partnership for sustainable malaria prevention. http://www.netmarkafrica.org/research/quantitative/CrossCountryQuan2001.pdf.
  22. D’Alessandro U, Aikins MK, Langerock P, Bennett S, Greenwood BM, 1994. Nationwide survey of bednet use in rural Gambia. Bull World Health Organ 72 : 391–394. [Google Scholar]
  23. Snow RW, Schellenberg JR, Forster D, Mung’ala VO, Marsh K, 1994. Factors influencing admission to hospital during terminal childhood illnesses in Kenya. Int J Epidemiol 23 : 1013–1019. [Google Scholar]
  24. Bradley AK, Greenwood BM, Greenwood AM, Marsh K, Byass P, Tulloch S, Hayes R, 1986. Bed-nets (mosquito-nets) and morbidity from malaria. Lancet 2 : 204–207. [Google Scholar]
  25. Aikins MK, Pickering H, Greenwood BM, 1994. Attitudes to malaria, traditional practices and bednets (mosquito nets) as vector control measures: a comparative study in five west African countries. J Trop Med Hyg 97 : 81–86. [Google Scholar]
  26. van Bortel W, Delacollette C, Barutwanayo M, Coosemans M, 1996. Deltamethrin-impregnated bednets as an operational tool for malaria control in a hyper-endemic region of Burundi: impact on vector population and malaria morbidity. Trop Med Int Health 1 : 824–835. [Google Scholar]
  27. Armstrong Schellenberg JRM, Abdulla S, Minja H, Nathan R, Mukasa O, Marchant T, Mponda H, Kikumbih N, Lyimo E, Manchester T, Tanner M, Lengeler C, 1999. KINET: a social marketing programme of treated nets and net treatment for malaria control in Tanzania, with evaluation of child health and long-term survival. Trans R Soc Trop Med Hyg 93 : 225–231. [Google Scholar]
  28. Binka FN, Adongo P, 1997. Acceptability and use of insecticide impregnated bednets in northern Ghana. Trop Med Int Health 2 : 499–507. [Google Scholar]
  29. Lubanga RG, Norman S, Ewbank D, Karamagi C, 1997. Maternal diagnosis and treatment of children’s fever in an endemic malaria zone of Uganda: implications for the malaria control programme. Acta Trop 68 : 53–64. [Google Scholar]
  30. Dunyo SK, Afari EA, Koram KA, Ahorlu CK, Abubakar I, Nkrumah FK, 2000. Health centre versus home presumptive diagnosis of malaria in southern Ghana: implications for home-based care policy. Trans R Soc Trop Med Hyg 94 : 285–288. [Google Scholar]
  31. Einterz EM, Bates ME, 1997. Fever in Africa: do patients know when they are hot? Lancet 350 : 781. [Google Scholar]
  32. Nicoll A, 2000. Integrated management of childhood illness in resource-poor countries: an initiative from the World Health Organization. Trans R Soc Trop Med Hyg 94 : 9–11. [Google Scholar]
  33. Nevill CG, Some ES, Mung’ala VO, Mutemi W, New L, Marsh K, Lengeler C, Snow RW, 1996. Insecticide-treated bednets reduce mortality and severe morbidity from malaria among children on the Kenyan coast. Trop Med Int Health 1 : 139–146. [Google Scholar]
  34. Binka FN, Kubaje A, Adjuik M, Williams LA, Lengeler C, Maude GH, Armah GE, Kajihara B, Adiamah JH, Smith PG, 1996. Impact of permethrin impregnated bednets on child mortality in Kassena-Nankana district, Ghana: a randomized controlled trial. Trop Med Int Health 1 : 147–154. [Google Scholar]

Data & Media loading...

  • Received : 21 Aug 2003
  • Accepted : 15 Nov 2003

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error